VIDEO: Demonstration of the LifeVest Wearable Defibrillator System

The Zoll LifeVest is a temporary, wearable defibrillator designed as a safety net for patients, especially those being evaluated for a permanent implantable cardioverter defibrillator (ICD). The Vest Prevention of Early Sudden Death Trial (VEST), presented at ACC 2018, was the first randomized, controlled, multi-center trial of the wearable cardioverter defibrillator. It looked to see if this device could effectively reduce sudden death in patients who had recently suffered a heart attack and had reduced heart function. Read more about the VEST Trial.

This is a sample of the 3-D printed hearts and coronary anatomy models created from patient CT scans to enable anatomical assessment, device sizing and plan which devices to use and navigation for complex structural heart cases at Henry Ford Hospital, Detroit, Mich. These hearts are in the office of Dee Dee Wang, M.D., director of structural heart imaging, at Henry Ford. She is in charge of a robust 3-D printing program to aid the structural heart program, which surpassed its 1,000th patient printed heart earlier in 2019.

This is a walk through of the primary structural heart hybrid cath lab at Henry Ford Hospital in Detroit, Mich. It is the hospital's newest lab and is centered around a Philips Azurion angiography system, which is a low dose imaging system that significantly reduces dose exposure compared to previous generation systems. As seen in the video, the lab is also equipped with a vascular access ultrasound system, transesophageal echo (TEE) system, an Abiomed Impella console, a large number of storage cabinets, surgical lighting for cases that convert over to open surgery or for transapical TAVR access, movable radiation shielding and ample space to accommodate surgical equipment and extra staff involved in structural heart procedures. There also is an electrosurgical cutter unit in the lab, which Henry Ford operators use to perform transcaval access TAVR procedures for patients who have anatomical challenges to the femoral access route.

A demonstration of how to calculate the neo-left ventricular outflow tract (neo-LVOT) on CT imaging for a transcatheter mitral valve replacement using Circle Imaging's advanced visualization software. The demonstration looks at the use of an Edward's Sapien valve being implanted for a mitral valve-in-valve procedure. The overhang of the Sapien can block the LVOT blood flow, which can be catastrophic for the patient. So, assessment of the neo-LVOT in a simulation of the implant is required prior to the procedure to find the ideal landing zone and assess if the patient's anatomy is compatible with this technique.

This is an example of a carotid artery reporting module from Change Healthcare at 2018 Radiological Society of North America (RSNA) annual meeting. It shows how the PACS can bring in ultrasound imaging of the carotid artery and the graphical report can be modified to match the patient anatomy. The text and modifications made to the vessel tree convert into text to help auto-fill fields in the written report to help speed workflow. The vessel tree is similar to cath lab reporting systems that use a similar model of the coronaries that can be modified and helps auto complete the cath report.

Interview with John Carroll, M.D., director of interventional cardiology, Robert Quaife, M.D., director of advanced cardiac imaging, and James Chen, Ph.D., associate professor of medicine and director of the 3-D imaging lab at the Cardiac and Vascular Center at the University of Colorado Hospital. They discuss how the structural heart program was created and how they invested in advanced imaging to grew into one of the most advanced programs in the country. They explain how the program now incorporates transcatheter aortic valve replacement (TAVR), transcatheter mitral valve repair, transcatheter mitral valve replacement (TMVR), left atrial appendage (LAA) occlusion and transcatheter closure of holes in the heart.

The heart team in this video stressed the need for advanced imaging to plan and guide the procedures. They explain how the center developed its own 3-D imaging software and worked with Philips healthcare to commercialize some of the technologies, including the EchoNavigator system used to fuse live angiography with live transesophageal echo (TEE).

John Carroll, M.D., FACC, FSCAI, director of interventional cardiology and co-director of the Cardiac and Vascular Center at the University of Colorado Hospital, offers an overview of the Society of Thoracic Surgeons and American College of Cardiology (STS/ACC) Transcatheter Valve Therapy (TVT) Registry and how it is being used. The data from the registry is being used to accelerate advancement of transcatheter valve repair and replacement technology and facilitate faster regulatory reviews. This included the FDA's adding of a new indication for the use of current TAVR valves for valve-in-valve procedures. The registry also offers comparisons for things like surgical aortic valve replacement (SAVR) vs. transcatheter aortic valve replacement (TAVR) and how procedural volume impacts outcomes.

Alex Haak, Ph.D., clinical scientist at Philips Health Systems North America, is based at the University of Colorado Hospital, to work directly with physicians in the cath lab to gather immediate feedback and improve next generation fusion imaging technologies used for structural heart interventions. Philips worked with the University of Colorado to develop the EchoNavigator, which fuses 3-D anatomical imaging, live transesophageal echo (TEE) and live fluoroscopy in the cath lab to help guide structural heart procedures. Haak is permanently based at the hospital to help trouble shoot and tweak the new EchoNavigator and other interventional guidance technologies being alpha-tested there prior to final commercialization.

With Intellispace Enterprise Edition as the foundation, Philips Healthcare is connecting facilities and service areas within enterprises, while developing standards-based interoperability that preserves customers' investments and best of breed systems.

In this video, Meraj discuss a complex coronary intervention of a 77-year-old woman with stage 4 CKD, prior CABG, hypertension, hyperlipidemia, diabetes, who presented with angina and NSTEMI with an ejection fraction of 40 percent. The team at Northwell consulted with cardiac surgeons and the heart team, and determined that this patient was too high risk for another bypass surgery. Read more on this case.

Anderson discusses improving outcomes for patients in cardiogenic shock through the early use of mechanical circulatory support and the development of a shock protocol with the heart team. He outlines Hackensack University Medical Center’s multi-disciplinary, heart team approach in treatment decision-making for patients in cardiogenic shock. The team includes cardiac surgeons, interventional cardiologists, heart failure specialists and intensivists.

The patient, a 51-year-old male, was diagnosed with NYHA Class III non-ischemic systolic heart failure with an ejection fraction of 20 percent and an ICD. He presented to the emergency department with ICD shocks and his hemodynamics declined over a 12 hour period and blood work showed a 20 percent decline in kidney function. Amponsah placed a right heart cath and performed an echocardiogram showing LV dysfunction. The team decided to place an Impella CP in the cath lab to support the patient’s heart. This was effective in unloading the LV and organ perfusion. This also provided the team with time to transfer the patient to another facility.

Navin Kapur, M.D., discusses the results of the FDA STEMI Door-to-Unloading (DTU) safety and feasibility randomized controlled trial, presented as a late-breaking study at the 2018 American Heart Association meeting. Learn more at ProtectedPCI.com/DAIC.

In 2009, the GuideLiner Catheter revolutionized the concept of guide extension, creating new possibilities in interventional cardiology. Now in its third generation, the GuideLiner V3 Catheter continues to build on a history of innovation and performance — one that has been demonstrated with more than half a million catheters in cath labs around the world.

Teleflex also offers a family of Turnpike Catheters. These contain a robust multi-layer shaft that provides impressive flexibility, torque and tracking over a 0.014” guidewire in complex coronary and peripheral interventions. The unique five-layer composite shaft provides an ideal combination of flexibility and torque response to help navigate through complex anatomy while the outer polymer layer paired with a 60 cm distal hydrophilic coating facilitates smooth catheter delivery. This portfolio consists of the Turnpike Catheter (standard version), the Turnpike Spiral Catheter, the Turnpike Gold Catheter, and the Turnpike LP Catheter. Each catheter configuration contains a specific design element to address various clinical challenges in complex procedures

This year, Teleflex acquired two well-known PTCA balloon catheters. The Chocolate XD PTCA Balloon Catheter is a specialty angioplasty balloon, used in the pre-dilatation and treatment of coronary lesions. The balloon’s proprietary nitinol constraining structure creates “pillows” and “grooves” that are designed to provide controlled dilatation while minimizing vessel wall trauma.

The Glider PTCA Balloon Catheter is a semi-compliant balloon with a skived tip and low entry profile. The tip design, coupled with hydrophilic coating and an innovative, torqueable shaft, allows for precise tip orientation for use in crossing complex lesions and stent struts.

A demonstration of how to calculate the neo-left ventricular outflow tract (neo-LVOT) on CT imaging for a transcatheter mitral valve replacement using Circle Imaging's advanced visualization software. The demonstration looks at the use of an Edward's Sapien valve being implanted for a mitral valve-in-valve procedure. The overhang of the Sapien can block the LVOT blood flow, which can be catastrophic for the patient. So, assessment of the neo-LVOT in a simulation of the implant is required prior to the procedure to find the ideal landing zone and assess if the patient's anatomy is compatible with this technique.

This is an example of a carotid artery reporting module from Change Healthcare at 2018 Radiological Society of North America (RSNA) annual meeting. It shows how the PACS can bring in ultrasound imaging of the carotid artery and the graphical report can be modified to match the patient anatomy. The text and modifications made to the vessel tree convert into text to help auto-fill fields in the written report to help speed workflow. The vessel tree is similar to cath lab reporting systems that use a similar model of the coronaries that can be modified and helps auto complete the cath report.

With Intellispace Enterprise Edition as the foundation, Philips Healthcare is connecting facilities and service areas within enterprises, while developing standards-based interoperability that preserves customers' investments and best of breed systems.

Paul Chang, M.D., professor of radiology, vice chair of radiology informatics and medical director for enterprise imaging, University of Chicago, explains some of the issues with artificial intelligence (AI) and how hospitals can better prepare for its eventual implementation across the field medicine. A key takeaway is that hospitals need an infrastructure and roadway for AI and deep-learning algorithms to operate. Chang said most health systems will not invest directly in AI, but will invest in analytics, which Chang said uses much of the same infrastructure required by AI.

According to 2017 data provided by the Association of American Medical Colleges (AAMC), 40 percent of interventional cardiologists, 30 percent of cardiovascular disease specialists, and 26 percent of pediatric cardiologists in the United States are international medical graduates (IMGs). However, as the physician shortage continues to impact primary care doctors, psychiatrists, OB/GYNs, among others, the U.S. also expects to see a shortage of cardiologists within the next 10 years, according to a spotlight cardiology study issued by the professional services firm PYA, which specialized in healthcare consulting.

This is a walk through of the primary structural heart hybrid cath lab at Henry Ford Hospital in Detroit, Mich. It is the hospital's newest lab and is centered around a Philips Azurion angiography system, which is a low dose imaging system that significantly reduces dose exposure compared to previous generation systems. As seen in the video, the lab is also equipped with a vascular access ultrasound system, transesophageal echo (TEE) system, an Abiomed Impella console, a large number of storage cabinets, surgical lighting for cases that convert over to open surgery or for transapical TAVR access, movable radiation shielding and ample space to accommodate surgical equipment and extra staff involved in structural heart procedures. There also is an electrosurgical cutter unit in the lab, which Henry Ford operators use to perform transcaval access TAVR procedures for patients who have anatomical challenges to the femoral access route.

A demonstration of how to calculate the neo-left ventricular outflow tract (neo-LVOT) on CT imaging for a transcatheter mitral valve replacement using Circle Imaging's advanced visualization software. The demonstration looks at the use of an Edward's Sapien valve being implanted for a mitral valve-in-valve procedure. The overhang of the Sapien can block the LVOT blood flow, which can be catastrophic for the patient. So, assessment of the neo-LVOT in a simulation of the implant is required prior to the procedure to find the ideal landing zone and assess if the patient's anatomy is compatible with this technique.

This is an example of a carotid artery reporting module from Change Healthcare at 2018 Radiological Society of North America (RSNA) annual meeting. It shows how the PACS can bring in ultrasound imaging of the carotid artery and the graphical report can be modified to match the patient anatomy. The text and modifications made to the vessel tree convert into text to help auto-fill fields in the written report to help speed workflow. The vessel tree is similar to cath lab reporting systems that use a similar model of the coronaries that can be modified and helps auto complete the cath report.

Interview with John Carroll, M.D., director of interventional cardiology, Robert Quaife, M.D., director of advanced cardiac imaging, and James Chen, Ph.D., associate professor of medicine and director of the 3-D imaging lab at the Cardiac and Vascular Center at the University of Colorado Hospital. They discuss how the structural heart program was created and how they invested in advanced imaging to grew into one of the most advanced programs in the country. They explain how the program now incorporates transcatheter aortic valve replacement (TAVR), transcatheter mitral valve repair, transcatheter mitral valve replacement (TMVR), left atrial appendage (LAA) occlusion and transcatheter closure of holes in the heart.

The heart team in this video stressed the need for advanced imaging to plan and guide the procedures. They explain how the center developed its own 3-D imaging software and worked with Philips healthcare to commercialize some of the technologies, including the EchoNavigator system used to fuse live angiography with live transesophageal echo (TEE).

John Carroll, M.D., FACC, FSCAI, director of interventional cardiology and co-director of the Cardiac and Vascular Center at the University of Colorado Hospital, offers an overview of the Society of Thoracic Surgeons and American College of Cardiology (STS/ACC) Transcatheter Valve Therapy (TVT) Registry and how it is being used. The data from the registry is being used to accelerate advancement of transcatheter valve repair and replacement technology and facilitate faster regulatory reviews. This included the FDA's adding of a new indication for the use of current TAVR valves for valve-in-valve procedures. The registry also offers comparisons for things like surgical aortic valve replacement (SAVR) vs. transcatheter aortic valve replacement (TAVR) and how procedural volume impacts outcomes.

Alex Haak, Ph.D., clinical scientist at Philips Health Systems North America, is based at the University of Colorado Hospital, to work directly with physicians in the cath lab to gather immediate feedback and improve next generation fusion imaging technologies used for structural heart interventions. Philips worked with the University of Colorado to develop the EchoNavigator, which fuses 3-D anatomical imaging, live transesophageal echo (TEE) and live fluoroscopy in the cath lab to help guide structural heart procedures. Haak is permanently based at the hospital to help trouble shoot and tweak the new EchoNavigator and other interventional guidance technologies being alpha-tested there prior to final commercialization.

Dee Dee Wang, M.D., director of structural heart imaging, Henry Ford Hospital, Detroit, Mich., explains how patient survival depends on keeping the left ventricular outflow track (LVOT) clear and using 3-D imaging to predict what the neo-LVOT will look like prior to transcatheter mitral valve replacement (TMVR) procedures. The close proximity between the aortic and mitral valves in the left ventricle anatomy makes it critical to assess any mitral valve overhang that will obstruct blood flow out of the left ventricle. This issue has been raised in several cardiovascular imaging structural heart intervention planning sessions at conferences over the past two years, most notably at the Society of Cardiovascular Computed Tomography (SCCT).

This video offers an overview of the Watchman left atrial appendage (LAA) occluder system, including information of its design, implantation and clinical data supporting its use. Catheter-based LAA occlusion is used to seal off the LAA in the heart, which is the source of most stroke-causing clots in patients with atrial fibrillation (Afib). The device be used in place of anticoagulation therapy for stroke prevention.

This is a sample of the 3-D printed hearts and coronary anatomy models created from patient CT scans to enable anatomical assessment, device sizing and plan which devices to use and navigation for complex structural heart cases at Henry Ford Hospital, Detroit, Mich. These hearts are in the office of Dee Dee Wang, M.D., director of structural heart imaging, at Henry Ford. She is in charge of a robust 3-D printing program to aid the structural heart program, which surpassed its 1,000th patient printed heart earlier in 2019.

This is a walk through of the primary structural heart hybrid cath lab at Henry Ford Hospital in Detroit, Mich. It is the hospital's newest lab and is centered around a Philips Azurion angiography system, which is a low dose imaging system that significantly reduces dose exposure compared to previous generation systems. As seen in the video, the lab is also equipped with a vascular access ultrasound system, transesophageal echo (TEE) system, an Abiomed Impella console, a large number of storage cabinets, surgical lighting for cases that convert over to open surgery or for transapical TAVR access, movable radiation shielding and ample space to accommodate surgical equipment and extra staff involved in structural heart procedures. There also is an electrosurgical cutter unit in the lab, which Henry Ford operators use to perform transcaval access TAVR procedures for patients who have anatomical challenges to the femoral access route.

A demonstration of how to calculate the neo-left ventricular outflow tract (neo-LVOT) on CT imaging for a transcatheter mitral valve replacement using Circle Imaging's advanced visualization software. The demonstration looks at the use of an Edward's Sapien valve being implanted for a mitral valve-in-valve procedure. The overhang of the Sapien can block the LVOT blood flow, which can be catastrophic for the patient. So, assessment of the neo-LVOT in a simulation of the implant is required prior to the procedure to find the ideal landing zone and assess if the patient's anatomy is compatible with this technique.

This is an example of a carotid artery reporting module from Change Healthcare at 2018 Radiological Society of North America (RSNA) annual meeting. It shows how the PACS can bring in ultrasound imaging of the carotid artery and the graphical report can be modified to match the patient anatomy. The text and modifications made to the vessel tree convert into text to help auto-fill fields in the written report to help speed workflow. The vessel tree is similar to cath lab reporting systems that use a similar model of the coronaries that can be modified and helps auto complete the cath report.

Interview with John Carroll, M.D., director of interventional cardiology, Robert Quaife, M.D., director of advanced cardiac imaging, and James Chen, Ph.D., associate professor of medicine and director of the 3-D imaging lab at the Cardiac and Vascular Center at the University of Colorado Hospital. They discuss how the structural heart program was created and how they invested in advanced imaging to grew into one of the most advanced programs in the country. They explain how the program now incorporates transcatheter aortic valve replacement (TAVR), transcatheter mitral valve repair, transcatheter mitral valve replacement (TMVR), left atrial appendage (LAA) occlusion and transcatheter closure of holes in the heart.

The heart team in this video stressed the need for advanced imaging to plan and guide the procedures. They explain how the center developed its own 3-D imaging software and worked with Philips healthcare to commercialize some of the technologies, including the EchoNavigator system used to fuse live angiography with live transesophageal echo (TEE).

Alex Haak, Ph.D., clinical scientist at Philips Health Systems North America, is based at the University of Colorado Hospital, to work directly with physicians in the cath lab to gather immediate feedback and improve next generation fusion imaging technologies used for structural heart interventions. Philips worked with the University of Colorado to develop the EchoNavigator, which fuses 3-D anatomical imaging, live transesophageal echo (TEE) and live fluoroscopy in the cath lab to help guide structural heart procedures. Haak is permanently based at the hospital to help trouble shoot and tweak the new EchoNavigator and other interventional guidance technologies being alpha-tested there prior to final commercialization.

Dee Dee Wang, M.D., director of structural heart imaging, Henry Ford Hospital, Detroit, Mich., explains how patient survival depends on keeping the left ventricular outflow track (LVOT) clear and using 3-D imaging to predict what the neo-LVOT will look like prior to transcatheter mitral valve replacement (TMVR) procedures. The close proximity between the aortic and mitral valves in the left ventricle anatomy makes it critical to assess any mitral valve overhang that will obstruct blood flow out of the left ventricle. This issue has been raised in several cardiovascular imaging structural heart intervention planning sessions at conferences over the past two years, most notably at the Society of Cardiovascular Computed Tomography (SCCT).

Poterack said there is a brewing tsunami of data in wearable technologies that healthcare systems will have to figure out how to integrate in the coming years. He said the key issue with wearable data is that there needs to be outcomes data showing the value of how many steps a patient accumulates, changes in heart rate over time, or blood pressure changes in patients with specific aliments. Without this , he said there is limited value in the information.

This is a quick demo of the Schiller Cardiovit FT-1 electrocardiograph (ECG) system displayed at the Healthcare Information Management and Systems Society (HIMSS) 2019 meeting. It has a 3-D rendering of a patient showing where each lead needs to be placed. The user can rotate the images on the touch screen to see where the leads go and can easily identify where any issues are when the system automatically alerts them about misplaced leads. The goal is to improve and speed ECGs using a better form of visualization than the traditional black and white 2-D pictures. The system changes the lead place placements of the body rending based on the type of exam being performed using a drop down menu.

He said AI will play a big roll in imaging assessments of adult congenital heart disease to help relieve the burden on the small number of congenital cardiologists.

Chang also explained there is a tsunami of data about to wash over healthcare as wearable devices begin to be integrated into patient care. AI will play a key role in sorting through all this data by monitoring the information to identify trends or disease markers and alert clinicians and the patient.

He was a keynote speaker at HIMSS19 with his session "Synergies Between Man and Machine — Future AI apps can be directed to help mitigate physician burnout by decreasing the EHR burden, improving medical education, and automating quality improvement."

Chang is head of the artificial intelligence organization AIMed, which hosts educational sessions and an annual meeting on AI applications in medicine.

Sheba Medical Center in Israel has adopted an app that interfaces with various wearables and Bluetooth-enabled patient monitoring devices to create remote cardiac rehabilitation and heart failure programs. It now remotely monitors hundreds of patients and does not require them to come to the hospital for sessions, which has helped increase patient satisfaction and aided in increasing physical activity compliance. The app is able to transfer device data to an EMR so progress and tasks assigned to patients can be monitored without the need for them to come into the hospital for sessions. Klempfner recently wrote a paper on this topic.

How wearable devices will play a role in healthcare was a big topic at the Healthcare Information Management and Systems Society (HIMSS) 2019 meeting. The biggest question is how to attached the data from consumer devices into a usable format for clinicians that interfaces with the electronic medical record (EMR). A good example of how wearables are being integrated in clinical care was demonstrated by the company Datos. It offers software that can integrate data from a wide variety of wearable devices from several makers into a mobile app, It can transfer the information to an EMR. The app also offers two way communication between the patient and the doctor’s office. It can prompt patients with a list of things they need to do each day to reach physician specified goals and displays analytics on a patient’s health data, including charts and graphs.

The system is used by Sheba Medical Center in Israel for a remote cardiac rehabilitation program. It now remotely monitors hundreds of patients and does not require them to come to the hospital for sessions, which has helped increase patient satisfaction and aided in increasing physical activity compliance. Watch the VIDEO: Use of Wearable Medical Devices for Cardiac Rehabilitation — an interview with Robert Klempfner, M.D., director of the Cardiovascular Prevention Institute, Sheba Medical Center.

This video offers an overview of the Watchman left atrial appendage (LAA) occluder system, including information of its design, implantation and clinical data supporting its use. Catheter-based LAA occlusion is used to seal off the LAA in the heart, which is the source of most stroke-causing clots in patients with atrial fibrillation (Afib). The device be used in place of anticoagulation therapy for stroke prevention.

This is a virtual heart with the same electrophysiology characteristics as the real patient being developed to help optimize cardiac resynchronization therapy (CRT) lead placement. CRT currently has a 30 percent nonresponder rate, which is mainly due to the placement of leads. This model allows virtual placement of the leads In various locations to test response prior to the implantation procedure. The green dot shows the location of the virtual lead. It was unveiled at the Healthcare Information Management and Systems Society (HIMSS) 2019 annual meeting in February by Siemens. This "digital twin" technology is in development and will be able to create virtual, digital organs from a patient’s ECG, MRI scan and other clinical data. Siemens said the technology also might have applications for testing virtual ablations strategies to save procedure time when the patient is in the EP lab.

This is a sample of the 3-D printed hearts and coronary anatomy models created from patient CT scans to enable anatomical assessment, device sizing and plan which devices to use and navigation for complex structural heart cases at Henry Ford Hospital, Detroit, Mich. These hearts are in the office of Dee Dee Wang, M.D., director of structural heart imaging, at Henry Ford. She is in charge of a robust 3-D printing program to aid the structural heart program, which surpassed its 1,000th patient printed heart earlier in 2019.

A demonstration of how to calculate the neo-left ventricular outflow tract (neo-LVOT) on CT imaging for a transcatheter mitral valve replacement using Circle Imaging's advanced visualization software. The demonstration looks at the use of an Edward's Sapien valve being implanted for a mitral valve-in-valve procedure. The overhang of the Sapien can block the LVOT blood flow, which can be catastrophic for the patient. So, assessment of the neo-LVOT in a simulation of the implant is required prior to the procedure to find the ideal landing zone and assess if the patient's anatomy is compatible with this technique.

This is an example of a carotid artery reporting module from Change Healthcare at 2018 Radiological Society of North America (RSNA) annual meeting. It shows how the PACS can bring in ultrasound imaging of the carotid artery and the graphical report can be modified to match the patient anatomy. The text and modifications made to the vessel tree convert into text to help auto-fill fields in the written report to help speed workflow. The vessel tree is similar to cath lab reporting systems that use a similar model of the coronaries that can be modified and helps auto complete the cath report.

Interview with John Carroll, M.D., director of interventional cardiology, Robert Quaife, M.D., director of advanced cardiac imaging, and James Chen, Ph.D., associate professor of medicine and director of the 3-D imaging lab at the Cardiac and Vascular Center at the University of Colorado Hospital. They discuss how the structural heart program was created and how they invested in advanced imaging to grew into one of the most advanced programs in the country. They explain how the program now incorporates transcatheter aortic valve replacement (TAVR), transcatheter mitral valve repair, transcatheter mitral valve replacement (TMVR), left atrial appendage (LAA) occlusion and transcatheter closure of holes in the heart.

The heart team in this video stressed the need for advanced imaging to plan and guide the procedures. They explain how the center developed its own 3-D imaging software and worked with Philips healthcare to commercialize some of the technologies, including the EchoNavigator system used to fuse live angiography with live transesophageal echo (TEE).

Alex Haak, Ph.D., clinical scientist at Philips Health Systems North America, is based at the University of Colorado Hospital, to work directly with physicians in the cath lab to gather immediate feedback and improve next generation fusion imaging technologies used for structural heart interventions. Philips worked with the University of Colorado to develop the EchoNavigator, which fuses 3-D anatomical imaging, live transesophageal echo (TEE) and live fluoroscopy in the cath lab to help guide structural heart procedures. Haak is permanently based at the hospital to help trouble shoot and tweak the new EchoNavigator and other interventional guidance technologies being alpha-tested there prior to final commercialization.

Dee Dee Wang, M.D., director of structural heart imaging, Henry Ford Hospital, Detroit, Mich., explains how patient survival depends on keeping the left ventricular outflow track (LVOT) clear and using 3-D imaging to predict what the neo-LVOT will look like prior to transcatheter mitral valve replacement (TMVR) procedures. The close proximity between the aortic and mitral valves in the left ventricle anatomy makes it critical to assess any mitral valve overhang that will obstruct blood flow out of the left ventricle. This issue has been raised in several cardiovascular imaging structural heart intervention planning sessions at conferences over the past two years, most notably at the Society of Cardiovascular Computed Tomography (SCCT).

With Intellispace Enterprise Edition as the foundation, Philips Healthcare is connecting facilities and service areas within enterprises, while developing standards-based interoperability that preserves customers' investments and best of breed systems.